General Consent Form

Lash Lift / Tint
Brow Lamination
Brow Henna

Select a date

First Name

Last Name

Phone

Address

If 'YES', when was the last time?

I am informing my technician of the following conditions. Please mark all that apply.

Current use of eye drops or contact lenses, which I agree to remove during application.

Any allergies or sensitivities to instruments, adhesives, cleansers, or other solutions.

Other medical conditions, that can compromise the process and retention of this procedure.

Please carefully go over each point below:

I understand there are risks associated with eyelash or brow perm and/or henna. I understand that as part of the procedure excessive movement, talking, eye watering or eye twitching/blinking on my part may result in eye irritation, discomfort, and/or blurriness and could affect the final result.

I understand my eyes need to be closed and covered for the entire duration of up to 2 hours.

I understand the instruments, adhesives, cleansers, and solutions used may irritate my eyes or skin, I might require a physician’s follow-up care at my own expense.

I understand a patch test is recommended, and by skipping it I am proceeding at my own risk.

I understand that if I request to stop or leave during the procedure at any time, for any reason, after this consent is signed, that I will be responsible for the entire cost of the service(s).

I understand and agree to the care instructions for the following 24 hours after procedure:

No water can come in contact with the treatment area
Avoid activities with steam or heavy perspiration.
Do not disturb the treatment area, including rubbing or sleeping on them.

In failure to adhere to these instructions, I accept the consequences of the perm not lasting as expected.

This agreement will remain in effect for this procedure and all future procedures at Posh Lash. I release my technician and Posh Lash from all liability associated with this procedure, performed with the utmost attention to safety and proper application using tools and products that the technician has been professionally trained to use. I understand there are many factors that may affect the life of the result such as water and moisture contact, weather conditions, and activities involving exposure to high temperatures. I understand that due to pre-existing individual differences, a perfect or symmetrical result is not guaranteed, and there are also no guarantees for length of time the result will stay.

By signing below, I verify I have read, understand, and agree to the statements above and permission is granted to take photos and videos of my eyes/face which may be used for marketing purposes.

Your Signature (*or Guardian Signature if under 18 years old)

Thanks for submitting!

Important: When you press 'SUBMIT', please wait for a few seconds. A "Thanks for submitting!" prompt in green text will show below. This confirms the submission of the form. Thank you!

General Consent Form

Lash Lift / Tint

Brow Lamination

Brow Henna

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General Consent Form

Lash Lift / Tint

Brow Lamination

Brow Henna

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